News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
Sign In

Florida Rheumatologist Says UnitedHealthcare’s Management Program for Clinical Laboratory Tests Could Jeopardize Patient Care

Miami physician asks why UnitedHealthcare requires use of the BeaconLBS system for authorization for recommended medical laboratory tests that may help identify lymphoma early

In Florida, the confrontation between one of the nation’s largest health insurance corporations and physicians, clinical laboratory managers, and pathologists continues. The source of this confrontation are the restrictive and burdensome requirements for medical laboratory test ordering imposed last fall by UnitedHealthcare (NYSE:UNH) and administered by BeaconLBS, a business division of Laboratory Corporation of America (NYSE:LH).

For Florida rheumatologist Olga Kromo, M.D., UnitedHealthcare’s new decision-support system that physicians are required to use when ordering clinical laboratory tests is highly flawed. (more…)

UnitedHealthcare Pushes Back Start Date for Making Claims-Payment Decisions Based on its Florida Pilot Management Program for Medical Laboratory Tests

Health plan sets no new date for BeaconLBS claims-payment decisions but promises 30-days’ notice before making decisions on claims payment

Physicians, pathologists, and clinical laboratories in Florida got a late Christmas present last week. UnitedHealthcare (UHC) (NYSE:UNH) postponed the date when its medical laboratory benefit-management pilot program in Florida, administered by BeaconLBS, would affect claims payments.

This was welcome news, because, beginning January 1, if physicians serving UHC patients had failed to use the BeaconLBS system to obtain pre-notification or pre-authorization for 82 medical laboratory tests, the physicians or labs performing the tests would not be paid by UHC—nor could clinical labs and pathology groups in the UHC provider network bill patients for these tests. (more…)

Hospitals Take Steps to Drive Down Medical Errors in Their Emergency Departments

Clinical laboratory managers are often part of the ER’s process improvement team

Hospital emergency rooms (ER) across the country are intensifying their focus on improving patient safety  and reducing errors. The cost of malpractice lawsuits filed after errors in emergency rooms is a major reason why growing numbers of hospitals are initiating formal programs to identify and eliminate the source of errors and wrong care provided to patients.

It probably won’t surprise most pathologists and clinical laboratory managers to learn that diagnostic errors are one significant source of malpractice claims that result from care provided by hospital emergency rooms, which can often be chaotic and overcrowded. Recently, The Wall Street Journal reported that a large percentage of medical errors in hospitals—and the resulting malpractice suits—occur because of mistakes in the emergency room. Studies of closed claims show that 37% to 55% of the malpractice suits are attributable to diagnostic errors. (more…)

;